title: Adjustment and social support at work early after breast cancer surgery and its associations with sickness absence.
abstract: BACKGROUND
  As half of the women with breast cancer are of working ages and usually survive, knowledge is needed on how to support them early regarding work-related problems caused by treatments. Most previous studies have focused on individual and disease-related factors, whereas few have focused on work-related factors such as work adjustment and social support. The aim of this study was to investigate received and perceived social support from supervisor and colleagues as well as work adjustments, and their associations with sickness absence, among women who recently had had breast cancer surgery.
  
  
  METHODS
  Inclusion criteria were as follows: women aged 20-63 years, living in Stockholm County, treated surgically for a first diagnosis of breast cancer, literate in Swedish, without pre-surgical chemotherapy or known distant metastases. Included in the study were 605 women who worked at diagnosis and that had answered a questionnaire within eight weeks of inclusion. Descriptive statistics, univariate, and multivariable logistic regression analyses were applied to estimate odds ratios (OR) with 95% confidence intervals (CI) for the likelihood of being sickness absent.
  
  
  RESULTS
  Most women perceived and received social support and work adjustment after breast cancer surgery. Low adjustment (OR = 2.14; 95% CI, 1.45-3.18) and less social support (OR = 1.80; 95% CI, 1.16-2.78) were significantly associated with being sickness absent. Adjusting for sociodemographics, strenuous work posture, and treatment did not attenuate these associations.
  
  
  CONCLUSIONS
  Adjustment at work and social support from employer are associated with sickness absence and needs to be explored in discussions on return to work after breast cancer surgery.
authors.affiliation: Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Marie I
authors.initials: MI
authors.lastname: Nilsson
authors.forename: Lena-Marie
authors.initials: LM
authors.lastname: Petersson
authors.forename: Agneta
authors.initials: A
authors.lastname: Wennman-Larsen
authors.forename: Mariann
authors.initials: M
authors.lastname: Olsson
authors.forename: Marjan
authors.initials: M
authors.lastname: Vaez
authors.forename: Kristina
authors.initials: K
authors.lastname: Alexanderson
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D001943:Breast Neoplasms / Q000523:psychology* / Q000601:surgery; D003430:Cross-Sectional Studies; D004651:Employment / Q000523:psychology* / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D015999:Multivariate Analysis; D012307:Risk Factors; D018582:Sick Leave / Q000706:statistics & numerical data*; D012917:Social Adjustment; D012944:Social Support; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: adjustment; breast cancer; oncology; sick leave; social support; work